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一项对 179 例腰椎管狭窄退行性病变患者的研究,旨在评估保守治疗与手术减压在 12 个月时生活质量和残疾结局的差异。

A Study of 179 Patients with Degenerative Stenosis of the Lumbosacral Spine to Evaluate Differences in Quality of Life and Disability Outcomes at 12 Months, Between Conservative Treatment and Surgical Decompression.

机构信息

Department of Neurosurgery, Hospital St. Raphael in Cracow, Cracow, Poland.

Department of Histology, Cytophysiology and Embryology, Faculty of Medicine in Zabrze, Academy of Silesia, Katowice, Poland.

出版信息

Med Sci Monit. 2023 May 22;29:e940213. doi: 10.12659/MSM.940213.

Abstract

BACKGROUND This prospective study included 179 patients with degenerative stenosis of the lumbosacral spine and aimed to evaluate the outcomes of conservative treatment and surgical decompression on quality of life and disability over 12 months. MATERIAL AND METHODS The surgery group consisted of 96 patients with degenerative stenosis of the lumbosacral spine who qualified for surgical decompression, while the conservative-treatment group included 83 patients who qualified for conservative treatment. We used the Satisfaction with Life Scale questionnaire, the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) questionnaire, the Visual Analog Scale to assess the severity of pain, the Oswestry Low Back Pain Disability Questionnaire to assess the degree of disability, and the Sexual Satisfaction Scale at 0, 1, 6, and 12 months after treatment. RESULTS Statistical analysis showed a positive relationship between conservative and surgical treatment and quality of life (P<0.05). A significant reduction in the severity of pain (P<0.05) and the degree of disability (P<0.05) were both recorded during the 12-month followup period in both groups. Women of both groups declared significantly lower satisfaction than men at every time point (P<0.05). CONCLUSIONS Most patients in both groups declared an improvement in their quality of life, with the surgery group showing a higher percentage of responses that their quality of life had improved. Based on the results obtained from the FACIT-F questionnaire, degenerative stenosis of the lumbosacral spine had a non-root effect on the patients' lives in the surgery group.

摘要

背景

本前瞻性研究纳入了 179 例腰椎骶骨退行性狭窄患者,旨在评估 12 个月内保守治疗和手术减压对生活质量和残疾的影响。

材料与方法

手术组包括 96 例符合手术减压条件的腰椎骶骨退行性狭窄患者,而保守治疗组包括 83 例符合保守治疗条件的患者。我们使用生活满意度量表问卷、慢性疾病治疗功能评估疲劳量表(FACIT-F)问卷、视觉模拟评分法评估疼痛严重程度、Oswestry 下腰痛残疾问卷评估残疾程度,以及治疗后 0、1、6 和 12 个月的性满意度量表。

结果

统计分析显示,保守治疗和手术治疗与生活质量呈正相关(P<0.05)。两组在 12 个月的随访期间,疼痛严重程度(P<0.05)和残疾程度(P<0.05)均显著降低。两组女性在每个时间点的满意度均显著低于男性(P<0.05)。

结论

大多数患者在两组中都报告生活质量有所改善,手术组报告生活质量改善的比例更高。根据 FACIT-F 问卷的结果,腰椎骶骨退行性狭窄对手术组患者的生活没有神经根影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a296/10214874/b7c86c10bc5b/medscimonit-29-e940213-g001.jpg

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